Factores asociados al pronóstico funcional de pacientes con ictus isquémico agudo sometidos a trombectomía / Associated factors with functional prognosis of patients with acute ischemic stroke undergoing thrombectomy

Introducción: La trombectomía mecánica (TM) ha supuesto un cambio en la historia natural del ictus isquémico. Nos planteamos conocer factores asociados al pronóstico de los pacientes con ictus agudo tratados mediante TM en un hospital de tercer nivel de España.MétodosEstudio trasversal en 198 pacientes sometidos a TM por ictus isquémico agudo entre 2012 y 2020. Analizamos datos demográficos, factores de riesgo cerebrovascular, factores clínicos y radiológicos. Resultado valorado a los 90 días según la escala Rankin modificada (mRS), siendo favorable un mRS≤2 y desfavorable mRS≥3.ResultadosEdad media de 67,7±13,5 años, siendo el 50,5% mujeres. La hipertensión fue el factor de riesgo cerebrovascular más prevalente (65,7%). El valor National Institute of Health Stroke Scale (NIHSS) promedio basal fue 17,0(8,0;22,0). El 40,9% de los casos también recibió tratamiento fibrinolítico intravenoso. El 66,7% fueron realizados bajo sedación consciente. En promedio se realizaron 2 pases de TM, con una mediana de duración de 41 minutos. En el 79,9% la recanalización fue exitosa y el 59,5% presentaron un mRS≤2 a los 90 días. La edad, la DT2, el número de pases y la duración del procedimiento se asociaron con mRS≥3. La recanalización exitosa se asoció a un mRS≤2. Los modelos de regresión logística confirmaron la tendencia para edad (OR:1,56; IC%:1,11;2,20), DT2 (OR:3,51; IC%:1,38;8,97) y recanalización exitosa (OR:0,07; IC%:0,02;0,28).ConclusiónLa edad, la DT2 y el fracaso en la recanalización aumentan el riesgo de un resultado desfavorable a los 90 días en pacientes con ictus isquémico sometidos a TM. La duración de la intervención debería ser considerado como un posible factor pronóstico. (AU)

Introduction: Mechanical thrombectomy (MT) has meant a change in natural history of acute ischemic stroke. Our aim is to assess the possible association between different factors and prognosis in patients treated with MT in a third degree Spanish hospital.MethodsCross-sectional study including 198 patients underwent MT because of acute ischemic stroke between 2012 and 2020. Sociodemographic, vascular risk factors (VRF) and clinical-radiologic factors were recorded. Functional outcome was evaluated based on modified Rankin Scale (mRS) at 90 days, being mRS≤2 favorable and mRS≥3 unfavorable outcome.ResultsMean age 67.7±13.5 years, 50.5% women. Arterial hypertension was the most prevalent VRF (65.7%). National Institute of Health Stroke Scale (NIHSS) median value at admission was 17.0 (8.0; 22.0). 40.9% of cases also received fibrinolytic treatment. Conscious sedation was performed in 66.7% patients. Median passes of MT were 2, and median duration 41min. Successful recanalization was achieved in 79.9% and mRS≤2 at 90 days was registered at 59.5% cases. Age, type 2 diabetes (T2D), number of MT passes and procedure duration were associated with mRS≥3. Successful recanalization was associated with mRS≤2. Regression model confirmed these associations in age (OR: 1.56CI%: 1.11; 2.20); T2D (OR: 3.51CI%: 1.38; 8.97) and successful recanalization (OR: 0.07CI%: 0.02; 0.28).ConclusionAge, T2D and failed recanalization increase risk for unfavorable outcome at 90 days in patients with AIS treated with MT. Procedure time duration should be considered as a possible determinant factor in functional outcome. (AU)

Effect-Directed Synthesis of PhoP/PhoQ Inhibitors to Regulate Salmonella Virulence.

Salmonella spp. are among the leading bacterial causes of foodborne infections. The PhoP/PhoQ two-component regulatory system serves as a master virulence regulator in Salmonella. Although PhoP/PhoQ represents an ideal target for disarming Salmonella virulence, it has very few inhibitors reported so far. We describe a novel platform by which an inhibitor was selected out of around 185 compounds directly from reaction media containing thiosemicarbazones and mono-, di-, and trihydrazones. To achieve this, tandem library preparation, thin-layer chromatography (TLC) bioautography, and effect-directed deconvolution were applied. We illustrate the potential of this effect-directed synthesis for the identification of new useful bioactive compounds for the food field.

Effect-directed analysis in food by thin-layer chromatography assays.

Thin-layer chromatography (TLC) is widely used for food analysis and quality control. As an open chromatographic system, TLC is compatible with microbial-, biochemical-, and chemical-based derivatization methods. This compatibility makes it possible to run in situ bioassays directly on the plate to obtain activity-profile chromatograms, i.e., the effect-directed analysis of the sample. Many of the properties that can be currently measured using this assay format are related to either desired or undesired features for food related products. The TLC assays can detect compounds related to the stability of foods (antioxidant, antimicrobial, antibrowning, etc.), contaminants (antibiotics, pesticides, estrogenic compounds, etc.), and compounds that affect the absorption, metabolism or excretion of nutrients and metabolites or could improve the consumers health (enzyme inhibitors). In this article, different food related TLC-assays are reviewed. The different detection systems used, the way in which they are applied as well as selected examples are discussed.

Associated factors with functional prognosis of patients with acute ischemic stroke undergoing thrombectomy. / Factores asociados al pronóstico funcional de pacientes con ictus isquémico agudo sometidos a trombectomía.

INTRODUCTION: Mechanical thrombectomy (MT) has meant a change in natural history of acute ischemic stroke. Our aim is to assess the possible association between different factors and prognosis in patients treated with MT in a third degree Spanish hospital. METHODS: Cross-sectional study including 198 patients underwent MT because of acute ischemic stroke between 2012 and 2020. Sociodemographic, vascular risk factors (VRF) and clinical-radiologic factors were recorded. Functional outcome was evaluated based on modified Rankin Scale (mRS) at 90 days, being mRS≤2 favorable and mRS≥3 unfavorable outcome. RESULTS: Mean age 67.7±13.5 years, 50.5% women. Arterial hypertension was the most prevalent VRF (65.7%). National Institute of Health Stroke Scale (NIHSS) median value at admission was 17.0 (8.0; 22.0). 40.9% of cases also received fibrinolytic treatment. Conscious sedation was performed in 66.7% patients. Median passes of MT were 2, and median duration 41min. Successful recanalization was achieved in 79.9% and mRS≤2 at 90 days was registered at 59.5% cases. Age, type 2 diabetes (T2D), number of MT passes and procedure duration were associated with mRS≥3. Successful recanalization was associated with mRS≤2. Regression model confirmed these associations in age (OR: 1.56CI%: 1.11; 2.20); T2D (OR: 3.51CI%: 1.38; 8.97) and successful recanalization (OR: 0.07CI%: 0.02; 0.28). CONCLUSION: Age, T2D and failed recanalization increase risk for unfavorable outcome at 90 days in patients with AIS treated with MT. Procedure time duration should be considered as a possible determinant factor in functional outcome.

Pulling out a broken catheter using interventional radiology in a preterm. Neonatal intensive care.

There are different indications for the placement of a pleural drainage. It is indicated in a massive pneumothorax or a pleural effusion, and a tunnelled indwelling pleural catheter is put in place. As in any procedure, complications may occur. A broken catheter is a rare one, and when it occurs, it has to be removed by thoracoscopic surgery. This article describes the first case of a removal of a fractured pleural catheter in a preterm newborn with a bilateral pneumothorax using interventional radiology. We propose an alternative way less invasive that could enable a shorter recovery time with fewer complications.

Soybean (Glycine max) hull valorization through the extraction of polyphenols by green alternative methods.

Soybean is one of the greatest crops in the world, with about 348.7 million tons being produced in 2018. Soybean hull is a by-product produced during the processing of soybean to obtain flour and oil. Though not being actually exploited, it is a source of polyphenols with antioxidant activity. Here, the extraction of polyphenols from soybean hull was performed by means of an alkaline hydrolysis treatment, which was optimized by the response surface methodology. At the optimal region, a total phenolic content of 0.72 g gallic acid equivalents per 100 g of soybean hull was obtained with an antioxidant activity of 2.17 mmoles of Trolox equivalents. Polyphenols responsible for the antioxidant activities were identified by LC-MS, including phenolic acids, anthocyanins, stilbenes, and the two main isoflavones of soybean, daidzein and genistein, in their non-glycosylated form. Other alternative extraction methods based on Aspergillus oryzae fermentation and α-amylase hydrolysis are also proposed.

Effect directed synthesis of a new tyrosinase inhibitor with anti-browning activity.

The inhibition of enzymatic browning is an attractive target to elevate the quality of foods. The objective of this work is to describe a novel platform for the discovery of tyrosinase inhibitors, based on (a) one-pot preparation of a library of thiosemicarbazide compounds, (b) biological evaluation using tyrosinase TLC bioautography, (c) inhibitor identification via mass spectrometry coupled to bioautography. During these proof-of-concept experiments, the approach led to the straightforward identification of a new thiosemicarbazone with improved tyrosinase inhibition properties and fresh-cut apple slices antibrowning effect when compared to kojic acid. In conclusion, the platform represents an interesting strategy for the discovery of this type of inhibitors.

Biodegradation of aflatoxin B1 with cell-free extracts of Trametes versicolor and Bacillus subtilis.

Aflatoxin B1 (AFB1) is one of the most common contaminants of poultry feed and has been linked to adverse effects on animal health and productivity. In this study, the degradation of AFB1 was studied with cell-free extracts (CFE) of Trametes versicolor and Bacillus subtilis using High-Performance Liquid chromatography (HPLC). CFE from B. subtilis and T. versicolor gave 60% and 34% of AFB1 degradation respectively, while heat-inactivated extracts showed no degradation. By-products obtained at the end of AFB1 degradation were analyzed by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). After 96 h of incubation, by-products with lower m/z values were obtained with CFE from B. subtilis as compared to that from T. versicolor, indicating a higher degradation efficiency of the former. Additionally, the detection of a by-product which could correspond to AFB1-8,9 dihydrodiol - a less toxic derivative of AFB1 - after 72 and 96 h of incubation with CFE from B. subtilis, could indicate the simultaneous detoxification along with degradation of AFB1 by B. subtilis CFE.

Recovery of phenolic antioxidants from Syrah grape pomace through the optimization of an enzymatic extraction process.

Phenolic compounds are highly valuable products that remain trapped in grape pomace, an abundant winery by-product. Therefore, efficient extraction procedures of these compounds represent a route for grape pomace valorisation. Here we performed a screening of the factors affecting the aqueous enzymatic extraction of phenolic compounds from Syrah grape pomace, including the following independent variables: temperature, pH, pectinase, cellulase and tannase; and a subsequent optimization through response surface methodology. At the optimal region, the enzymatic treatment enhanced the extraction yield of phenolics by up to 66% and its antioxidant capacity by up to 80%, reducing the incubation time and enzyme doses in respect to previous studies. We found that tannase raises the antioxidant capacity of the extract by the liberation of gallic acid, while cellulose favours the liberation of p-coumaric acid and malvidin-3-O-glucoside. We also tested the procedure in different grape pomace varieties, verifying its wide applicability.

Molecular Networks in Dynamic Multilevel Systems.

Dynamic multilevel systems can be assembled from molecular building blocks through two or more reversible reactions that form covalent bonds. Molecular networks of dynamic multilevel systems can exhibit different connectivities between nodes. The design and creation of molecular networks in multilevel systems require control of the crossed reactivity of the functional groups (how to connect nodes) and the conditions of the reactions (when to connect nodes). In recent years, the combination of orthogonal and communicating reactions, which can be simultaneous or individually activated, has produced a variety of systems that have given rise to macrocycles and cages, as well as molecular motors and multicomponent architectures on surfaces. A given set of reactions can lead to systems with unique responsiveness, compositions, and functions as a result of the relative reactivities. In this Concept article, different molecular networks from synthetic systems that can be produced by combinations of different reaction types are discussed. Moreover, applications of this chemistry are highlighted, and future perspectives are envisioned.

Towards integral utilization of grape pomace from winemaking process: A review.

Grape is the main fruit crop in several countries. Although many grape-based food products can be found in the market, studies have shown that around 75% of the world grape production is destined for the wine industry. Grape pomace is an abundant by-product from the wine industry, which consists of the remaining skin, seeds and stalks and represents around 25% of total grape weight used in the winemaking process. In countries such as Italy, France and Spain, where wine production is more relevant, the annual grape pomace generation can reach nearly 1200 tonnes per year. In order to reach a sustainable winemaking process there is a need of a waste reduction policy. Several studies explore this subject using grape pomace as a source of healthy and technological compounds that could be applied in animal feed, pharmaceutical, cosmetic or food industry to improve stability and nutritional characteristics, and in cosmetic industry, where grape seeds oil is widely used. This review aims to approach the recent winemaking scenario and the benefits achieved when a waste management policy is implemented, as well as to compare available extractive technologies and a wide alternative of uses for grape pomace.

Antioxidant dietary fibre recovery from Brazilian Pinot noir grape pomace.

Brazilian grape pomace was extracted in hot water, and a factorial experiment was used to evaluate polysaccharide recovery. The dependent variables were the temperature, particle size and solute:solvent ratio. Polysaccharide yields varied from 3% to 10%, and the highest sugar content was observed when extraction was carried out at 100 °C from finely sized particles (⩽249 µm) in a 1:12 solute:solvent ratio. The monosaccharide composition of extracts obtained from flours were, on average, Rha:Ara:Xyl:Man:Gal:Glc:GalA in a 3:32:2:13:11:20:19 M ratio, with varying Glc:GalA ratios. (13)C NMR and HSQC spectra confirmed the presence of pectic- and glucose-based polysaccharides in the extracts. Phenolic compounds were found after pomace extraction, and catechin, gallic acid and epicatechin were the principal compounds identified. The extracts also had ABTS radical scavenging capacity (from 8.00 to 46.60 mMol Trolox/100 g pomace). These findings indicate that these grape pomace flours are rich in antioxidant dietary fibre and have a potential use as food ingredients.

Astringency reduction in red wine by whey proteins.

Whey is a by-product of cheese manufacturing and therefore investigating new applications of whey proteins will contribute towards the valorisation of whey and hence waste reduction. This study shows for the first time a detailed comparison of the effectiveness of gelatin and ß-lactoglobulin (ß-LG) as fining agents. Gelatin was more reactive than whey proteins to tannic acid as shown by both the astringency method (with ovalbumin as a precipitant) and the tannins determination method (with methylcellulose as a precipitant). The two proteins showed similar selectivity for polyphenols but ß-LG did not remove as much catechin. The fining agent was removed completely or to a trace level after centrifugation followed by filtration which minimises its potential allergenicity. In addition, improved understanding of protein-tannin interactions was obtained by fluorescence, size measurement and isothermal titration calorimetry (ITC). Overall this study demonstrates that whey proteins have the potential of reducing astringency in red wine and can find a place in enology.

Two-stage amplification of receptors using a multilevel orthogonal/simultaneous dynamic combinatorial library.

Sequential activation of different reversible exchange reactions in a dynamic combinatorial library allows directed exploration of the chemical space: initially a macrocyclic scaffold is selected by the template and finally side chain and conformational constrains are introduced into such a scaffold.